In:
Nephron Clinical Practice, S. Karger AG, Vol. 97, No. 1 ( 2004-11-17), p. c23-c30
Abstract:
〈 i 〉 Background/Aim: 〈 /i 〉 Brain atrophy is known to develop more rapidly in hemodialysis (HD) patients than other individuals. The present study was designed to examine the role of HD-related hypotension in brain atrophy in patients on chronic HD. 〈 i 〉 Methods: 〈 /i 〉 By using magnetic resonance imaging, whole brain atrophy was assessed by the ventricular-brain ratio (VBR; ventricular area/whole brain area). Frontal brain atrophy was assessed by the frontal atrophy index (FAI; frontal brain area/intracranial frontal space). The number of lacunae was also counted. We studied 32 HD patients without symptomatic neurological abnormalities or diabetes mellitus: male/female ratio 19/13; mean age ± SD 53 ± 10 (range 28–77) years; mean HD duration ± SD 11 ± 6 (range 1–22) years. Magnetic resonance imagings were taken in 1995 and 1998. All dialysis-related hypotension episodes during the same period were identified from the medical records and counted. 〈 i 〉 Results: 〈 /i 〉 The VBR ranged from 8.8 to 18.7% in 1995 (12.8 ± 2.2%) and was not different in 1998 (13.1 ± 2.7%). However, the VBR increased by more than 5% in 14 patients, and their HD duration of 13 ± 6 years was significantly longer than that of 18 patients with stable VBR (p 〈 0.05). The FAI in 1995 was 62.2 ± 4.2% (range 55.8–71.3%) and decreased significantly to 59.7 ± 4.7% (range 50.2–70.9%) in 1998 (p 〈 0.05). The change in FAI correlated significantly with both the total number of dialysis-related hypotension episodes (r = 0.45, p 〈 0.05) and the increase in number of lacunae (r = 0.42, p 〈 0.05). 〈 i 〉 Conclusion: 〈 /i 〉 Our results suggest that dialysis-related hypotension plays a role in progressive frontal lobe atrophy in HD patients.
Type of Medium:
Online Resource
ISSN:
1660-2110
Language:
English
Publisher:
S. Karger AG
Publication Date:
2004
detail.hit.zdb_id:
2098336-0
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